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2006 - 2012年美国急诊科治疗的孤立性与非孤立性轻度创伤性脑损伤的流行病学:社会人口学特征

Epidemiology of Isolated Versus Nonisolated Mild Traumatic Brain Injury Treated in Emergency Departments in the United States, 2006-2012: Sociodemographic Characteristics.

作者信息

Cancelliere Carol, Coronado Victor G, Taylor Christopher A, Xu Likang

机构信息

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada (Dr Cancelliere); and National Center for Injury Prevention and Control (Drs Taylor and Xu), Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Coronado).

出版信息

J Head Trauma Rehabil. 2017 Jul/Aug;32(4):E37-E46. doi: 10.1097/HTR.0000000000000260.

Abstract

OBJECTIVES

To describe the frequencies and rates of mild traumatic brain injury (mTBI) emergency department (ED) visits, analyze the trend across the years, and compare sociodemographic characteristics of visits by mTBI type (ie, mTBI as the only injury, or present along with other injuries).

DESIGN

Population-based descriptive study using data from the Nationwide Emergency Department Sample (2006-2012).

METHODS

Joinpoint regression was used to calculate the average annual percent changes of mTBI incidence rates. Characteristics between isolated and nonisolated visits were compared, and the odds ratios were reported.

RESULTS

The rate per 100 000 population of mTBI ED visits in the United States increased significantly from 569.4 (in 2006) to 807.9 (in 2012). The highest rates were observed in 0- to 4-year-olds, followed by male 15- to 24-year-olds and females 65 years and older; the lowest rates were among 45- to 64-year-olds. The majority (70%) of all visits were nonisolated and occurred more frequently in residents of metropolitan areas. Falls were the leading external cause. Most visits were privately insured or covered by Medicare/Medicaid, and the injury occurred on weekdays in predominantly metropolitan hospitals in the South region.

CONCLUSIONS

The burden of mTBI in US EDs is high. Most mTBI ED visits present with other injuries. Awareness of sociodemographic factors associated with nonisolated mTBI may help improve diagnosis in US EDs. This information has implications for resource planning and mTBI screening in EDs.

摘要

目的

描述轻度创伤性脑损伤(mTBI)患者急诊科(ED)就诊的频率和发生率,分析多年来的变化趋势,并比较不同类型mTBI(即单纯mTBI或合并其他损伤)就诊患者的社会人口学特征。

设计

基于人群的描述性研究,使用来自全国急诊科样本(2006 - 2012年)的数据。

方法

采用Joinpoint回归分析计算mTBI发生率的年均变化百分比。比较单纯性和非单纯性就诊患者的特征,并报告优势比。

结果

美国每10万人中mTBI患者的急诊科就诊率从2006年的569.4显著上升至2012年的807.9。0至4岁儿童的就诊率最高,其次是15至24岁男性和65岁及以上女性;45至64岁人群的就诊率最低。所有就诊患者中,大多数(70%)合并其他损伤,且在大都市地区居民中更为常见。跌倒为主要外部致伤原因。大多数就诊患者有私人保险或由医疗保险/医疗补助覆盖,损伤多发生在工作日,主要是南部地区大都市的医院。

结论

美国急诊科mTBI的负担较重。大多数mTBI患者合并其他损伤。了解与非单纯性mTBI相关的社会人口学因素可能有助于改善美国急诊科的诊断。该信息对急诊科的资源规划和mTBI筛查具有重要意义。

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